BACKGROUND: 
Paediatric SLT roles often involve planning individualised intervention for specific children (provided directly by SLTs or indirectly through non-SLTs), working collaboratively with families and education staff and providing advice and training. A tiered approach to service delivery is currently recommended, whereby services become increasingly specialised and individualised for children with greater needs.

AIMS: 
To examine 1) evidence of intervention effectiveness for children with language disorders at different tiers and 2) evidence regarding SLT roles; and to propose an evidence-based model of SLT service delivery.

METHODS: 
Controlled, peer-reviewed studies, meta-analyses and systematic reviews of interventions for children with language disorders are reviewed and their outcomes discussed, alongside the differing roles SLTs play in these interventions. We indicate where gaps in the evidence base exist and present a possible model of service delivery consistent with current evidence, and a flowchart to aid clinical decision making.


MAIN CONTRIBUTION: 
The service delivery model presented resembles the tiered model commonly used in education services, but divides individualised (Tier 3) services into Tier3A: indirect intervention delivered by non-SLTs, and Tier 3B: direct intervention by an SLT. We report the evidence for intervention effectiveness and which children might best be served by each tier, the role SLTs could take within each, and the evidence of effectiveness of these roles. Regarding universal interventions provided to all children (Tier 1) and those targeted at children with language weaknesses (Tier 2), there is growing evidence that approaches led by education services can be effective when staff are highly trained and well-supported. There is currently limited evidence regarding additional benefit of SLT-specific roles at Tiers 1 and 2. With regard to individualised intervention (Tier 3): children with complex or pervasive language disorders progress significantly following direct individualised intervention (Tier 3B), whereas children with milder or less pervasive difficulties can make progress when intervention is managed by an SLT, but delivered indirectly by others (Tier 3A), provided they are well-trained, -supported and -monitored.


CONCLUSIONS: 
SLTs have a contribution to make at all tiers, but where prioritisation for clinical services is a necessity, we need to establish the benefits and cost-effectiveness of each contribution. Good evidence exists for SLTs delivering direct individualised intervention, and we should ensure that this is available to those children with pervasive and/or complex language impairments. In cases where service models are being provided which lack evidence, we strongly recommend that SLTs investigate the effectiveness of their approaches.

/pdf/evidence-based-pathways-to-intervention-for-children-with-1qcpu8u0re.pdf

Evidence-based pathways to intervention for children with language disorders

This systematic review explores the impact of teacher professional development (PD) on student reading achievement. The first part of the literature evaluates all available existing systematic reviews and meta-analyses of PD intervention studies. No quality reviews of PD and reading specifically (distinct from ‘attainment’) were found. There was a little overlap of studies in existing reviews. The second part of the systematic review focuses on the most recent intervention studies exploring PD and student reading achievement. The results of a meta-analysis of all high-quality studies are presented in the third part of the paper. This analysis showed no strong evidence of publication bias and an effect size for PD on student literacy of g = 0.225. This effect was moderated by the number of hours of PD whereby studies with fewer than 30 h of PD was significant for student reading outcomes (g = 0.367, p   .05). Following a Weight of Evidence assessment, analysis showed that nearly all high-quality articles involved shorter PD. Weight of Evidence was a significant moderator, (g = 0.408, p   0.5, n.s., for medium quality studies). Our review suggests that only high-quality studies of short teacher PD currently provide evidence of impact on student’s reading achievement.

/pdf/teacher-professional-development-and-student-literacy-growth-5a3hdeg1xy.pdf

Teacher Professional Development and Student Literacy Growth: A Systematic Review and Meta-Analysis.

Annual Research Review: The nature and classification of reading disorders – a commentary on proposals for DSM-5

Children who begin school with proficient language skills are more likely to develop adequate reading comprehension abilities and achieve academic success than children who struggle with poor language skills in their early years. Individual language difficulties, environmental factors related to socioeconomic status (SES), and having the educational language as a second language are all considered risk factors for language and literacy failure. Intervention programs have been designed with the aim of supporting at‐risk children’s language skills. In these programs, the instructional methods typically include a strong focus on vocabulary instruction within the context of storytelling or text reading. Elements that directly activate narrative and grammatical development are often included. What is the aim of this review? This Campbell systematic review examines the effects of linguistic comprehension instruction on generalized measures of language and reading comprehension skills. The review summarizes evidence from 43 studies, including samples of both preschool and school‐aged participants.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/cl2.1059

The effect of linguistic comprehension instruction on generalized language and reading comprehension skills: A systematic review

Purpose This article is concerned with the growing body of international evidence indicating that adolescents in contact with the youth justice system are likely to have severely compromised oral l...

https://pubs.asha.org/doi/pdf/10.1044/2018_LSHSS-CCJS-18-0027

Speech-Language Pathology and the Youth Offender: Epidemiological Overview and Roadmap for Future Speech-Language Pathology Research and Scope of Practice.

This study examined the impact of teacher professional development aimed at improving the capacity of primary teachers in disadvantaged schools to strengthen children's expressive and receptive ora...

Brenda Dalheim

Papers

Oral language supports early literacy: A pilot cluster randomized trial in disadvantaged schools